Because no one knows more about diet, exercise, and weight loss than a fat person . . .

If diet and exercise were all that there was to being thin . . .

If diet and exercise were all that there was to being thin . . . Well, okay, so it's diet and exercise . . . I kid! I kid!

Tuesday, December 7, 2010

HERNIATED DISC, KNEE REPLACEMENT, NARCOTICS . . . OH MY!

Ladies and gentlemen, a doom-ish date draws nigh. Until now I have neglected to share with you that this holiday season does not hold for me visions of sugarplums dancing in my head (Mmm, sugarplums!). No, instead this holiday season will be spent recuperating from two separate surgeries. Allow me to share with you an MRI of my neck, taken last Monday 11/29/10. For your convenience I have labeled the sideslice view of my noggin for greater clarification:

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If you can’t read the font, the vertical text reads “spinal cord,” the first horizontal text reads “bulging disc,” and the second horizontal text also reads “bulging disc.” As you can see, C5 has fully herniated and is pressing against my spinal cord. C4 is bulging slightly.

One thing about me: my health is infuriatingly testy. For some reason, I am prone to orthopedic injuries and weird, random ailments that perplex my doctors and myself. Subsequently, I have no idea how I turned up with a herniated disc. Seriously. There was no injury, no fall, no accident, no one thing that would have overtly led me to believe that I had herniated a cervical disc. Well, okay, let's back up.

In August, I noticed that the baby toe and the fourth toe on my right foot were completely numb. I chalked it up to a pinched nerve, from me sitting Indian-style on the couch when I'd be laptopping, because I kind of tuck my right foot up under my left thigh. But then I noticed the pinky finger and ring finger on my right hand was starting to feel numb, but it was really faint and very transitory numbness. However, I found it odd that it was the same digits on both the right foot and the right hand that were experiencing the numbness.

In September, I woke up one morning and couldn’t turn my head to the left without a lot of pain, and suddenly there was a severe burning sensation in my neck, going all the way down my left shoulder blade. There was no comfortable position I could find to sit in, and this lasted for about a week. By the time that week was over, my neck was kinked into this bizarre position that made me look like a turtle poking its head out of its shell. I kept thinking, you know, that it would get better, that I had just pulled my neck or whatever (don't ask me why I didn't realize how serious this was) and finally my mother was like Get thee to a doctor for thy neck is in the shape of a pretzel. So, yeah, the MRI revealed the herniated disc.

I'm having what's called an ACDF procedure on the 14th, where my surgeon will go in and remove the ruptured disc and place a small prosthetic device in between the cervical bones to hold the spine steady and to keep the cervical bones from grinding together.

I’m freaking out, one, because it’s spinal surgery and that squicks me out. Two, the surgeon goes in through the throat so the incision will be in the front of my neck and I’ll have a scar there where everyone will be able to see it. I won’t be able to hide the scar unless I wear a turtleneck, and I don’t wear turtlenecks (they’re so 1990!). I’ll be in the hospital overnight.

Following the surgery I won’t be allowed to lift anything. I can move things that are less than five pounds, but I’m not going to be allowed to do very much, including bending and stooping, making rapid side to side motions, or moving my neck around excessively. I guess the upside is that this will include doing things like laundry or cooking (Hey, Mom’s got a few weeks off!). The downside is that on December 27th . . .

. . . I am having a full left knee replacement done.

Yeah.

Why am I not postponing the knee surgery, you may be asking? Simple. We’ve met our $5000 medical deductible for the 2010 calendar year; if I wait to do the knee surgery until after the first of the year, then we will have a whole new $6000 deductible to pay (it went up for 2011) and I would like to avoid that. So I’m pushing this through and am plunging ahead with two major surgeries within two weeks time.

The knee replacement has been a long time in coming. I’ve had bad knees since I was a teen – I had my first knee surgery for plica syndrome when I was fifteen, and my second when I was sixteen. For some reason my knees have deteriorated much more quickly than one would expect for someone my age, and here I am at 41 needing two full knee replacements. Aside from my two earlier knee surgeries, I’ve done physical therapy, massage, exercises, stretching, icing, heat, lidocaine patches, and pain management. As I don’t want to live the rest of my life on pain management, I made the decision to go ahead and start the knee replacement process. I’ll do my left knee first, as it’s far more deteriorated, and then will do the right knee at a later date. The whole idea of having an entire joint replaced seriously grosses me out – I don’t even have words for how squicky I find the prospect to be. But, you know, it’s this or pain management.

I don’t like pain management; I don’t like pills or medications; I don’t like the side-effects of pain medication. Pain meds don’t make me feel dopey or anything, but they do affect my mood (WHEE! BooHiss). I’ve had people tell me I’m lucky that I have access to pain management because – unbelievable!-- “those are the good drugs.” They are not the “good” drugs, especially if one is sensitive to opioids – who wants to spend their time nauseated and popping Zofran?

Fear of the surgery has kept me from having my knees replaced until now (I’ve been on pain management for three years), but now I feel like I’m on a hamster wheel of pain management and unless I do something, I will be stuck in this narcotic rut forever! I mean, pain management is highly regulated, as it should be. By saying “narcotic rut” I make it sound far more insidious than it really is. When you’re on pain management, basically you have a contract with your pain physician that you will only use him or her for your pain needs; this is to prevent people from doctor shopping, i.e. going from doctor to doctor to doctor seeking pain meds (this is an addictive behavior, though, not the behavior of a legitimate pain patient).

I’m required to bring in my medications once per month so the clinic can monitor them; I have to go in person to get a new prescription every month, and they do random urinalysis to ensure I am taking only the prescribed dose or less. I have no problem jumping through their hoops. A month hasn’t gone by that I haven’t had leftover medications – I never end up taking as much as I’m prescribed. Typically I will need a dose of pain meds at the end of the day or after I’ve been on my feet for a protracted length of time. I will sometimes need a second dose before bed because the pain can actually be severe enough to keep me from sleeping or to wake me up out of a dead sleep. Most days I just require one dose, though.

I went through a lot of trial and error to find the right combination of medications. Some medications worked really well, but only via IV or intramuscular (Demerol, which is not frequently used anymore anyway, because it apparently has a high risk for seizures). Some medications made me excessively itchy and really nauseated (Dilaudid). Some medications made me COMATOSE OMG *ZOMBIE* (Fentanyl). Some weren’t strong enough (Vicodin). So I’m currently prescribed Oxycodone* 15 mgs three times per day and 30 mgs Morphine three times per day. I typically take one dose of Oxycodone and one dose of Morphine.

This reminds me of something I’ve ranted about to friends before. Any of you watch House? I grudgingly watch House, and while I’ll save the meta critique for TWOP as to why I find it to be an imperfect show with an unredeemingly unlikeable character (House) who is in fact not endearing, I will criticize House here for one major faux pas: You cannot tell me that an addiction to Vicodin is plausible. Here we have a man with a serious leg injury and ongoing chronic pain. As well, he is a physician. Not in a million years do I buy the premise that a physician with regular access to narcotic medications would stop at Vicodin, a low level narcotic pain reliever. It’s like trying to get me to believe that an Afghani poppy farmer has an addiction to extra-strength Tylenol. Whatevs, House. Whatevs! You know as well as I do that House, if plausibly written, would have been hitting the morphine, the dilaudid, the fentanyl, the oxycontin, the soma, etc, in the position he’s in with the access to drugs that he has. Vicodin? Oh, please. House may as well be gnawing on a candy necklace, as plausible as Vicodin is. Writers? FAIL.

And there’s the possum in the bathtub incident, but that’s a whole ‘nother post.

*Please note that Oxycodone is not Oxycontin, the latter being an extremely powerful and highly addictive narcotic.

**Wow, you may be thinking, you sure are long-winded. The answer to this is: Yes. That, and I type really fast.

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Chase FATG:

Fatty, Fatty! Two by Four!

Fat at the Gym weighs 216 pounds and has been varying weights throughout her life. FATG went on her first diet at age 11 (Weight Watchers), attended her first OA meeting at 14, and has endured every diet known to mankind, as well as fat camp as a kid/teen; in 2007 she underwent roux-en-y gastric bypass surgery. FATG has food issues. FATG is not soliciting dieting, exercise, or fitness tips; FATG already has her Ph.D. in How Not to Be Fat. FATG fears pigeons, metal handrails, cockroaches, and yoga, the latter lest she suffocate in her own stomach fat. When not flailing around madly at 24 Hour Fitness, FATG can be found spending time with her lovely family and pug and poodle, cooking fancy cuisine, reporting her horrible neighbors to the Denver Police Department for their daily noise violations, reading, sewing and making fabric art, fighting her various neuroses and irrational anxieties, advocating for the homeless and individuals with mental illness, caring for her fish aquarium, keeping house, wearing black clothing, being a raging, bleeding-heart liberal, and stalking myfooddiary.com. FATG lives in a 120-year-old Victorian in Denver, Colorado.